1
|
Determinants of Knowledge and Attitude towards Breastfeeding in Rural Pregnant Women Using Validated Instruments in Ethiopia. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18157930. [PMID: 34360225 PMCID: PMC8345493 DOI: 10.3390/ijerph18157930] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/04/2021] [Revised: 07/15/2021] [Accepted: 07/17/2021] [Indexed: 11/16/2022]
Abstract
Understanding the underlying determinants of maternal knowledge and attitude towards breastfeeding guides the development of context-specific interventions to improve breastfeeding practices. This study aimed to assess the level and determinants of breastfeeding knowledge and attitude using validated instruments in pregnant women in rural Ethiopia. In total, 468 pregnant women were interviewed using the Afan Oromo versions of the Breastfeeding Knowledge Questionnaire (BFKQ-AO) and the Iowa Infant Feeding Attitude Scale (IIFAS-AO). We standardized the breastfeeding knowledge and attitude scores and fitted multiple linear regression models to identify the determinants of knowledge and attitude. 52.4% of the women had adequate knowledge, while 60.9% of the women had a neutral attitude towards breastfeeding. In a multiple linear regression model, maternal occupation was the only predictor of the BFKQ-AO score (0.56SD; 95%CI, 1.28, 4.59SD; p = 0.009). Age (0.57SD; 95%CI, 0.24, 0.90SD; p = 0.001), parity (-0.24SD; 95%CI, -0.47, -0.02SD; p = 0.034), antenatal care visits (0.41SD; 95%CI, 0.07, 0.74SD; p = 0.017) and the BFKQ-AO score (0.08SD; 95% CI, 0.06, 0.09SD; p < 0.000) were predictors of the IIFAS-AO score. Nearly half of the respondents had inadequate knowledge and most women had a neutral attitude towards breastfeeding. Policymakers and managers could address these factors when planning educational interventions to improve breastfeeding practices.
Collapse
|
2
|
Tie WJ, Kent JC, Tat Lai C, Rea A, Hepworth AR, Murray K, Geddes DT. Reproducibility of the creamatocrit technique for the measurement of fat content in human milk. Food Chem 2021; 356:129708. [PMID: 33845253 DOI: 10.1016/j.foodchem.2021.129708] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2020] [Revised: 02/24/2021] [Accepted: 03/23/2021] [Indexed: 10/21/2022]
Abstract
Quantification of human milk (HM) fat is important for determining the energy intake of infants. The simplest and most rapid method is the creamatocrit method. However, the reliability of the creamatocrit has not been comprehensively investigated. The aims of this study were to test the inter- and-intra-rater reliability of: 1) HM sampling after hand- or-machine mixing methods and 2) HM fat measurement by the creamatocrit method. Inter-and-intra rater HM sampling after hand- or-machine mixing methods had high intraclass correlation coefficient (>0.91). Inter-rater reliability of measurement of HM with low fat (<2%) resulted in high variability (median coefficient of variations (CVs) > 15%). Intra- and inter-rater reliability of measurement of HM with higher fat (>3.5%) had low variability (median CVs < 10%). As the greatest variation in the creamatocrit method occurred during the measurement of HM samples with low fat, duplicate readings are necessary to reduce discrepancies in every HM fat determination.
Collapse
Affiliation(s)
- Wan Jun Tie
- School of Molecular Sciences, The University of Western Australia, Perth, Western Australia, Australia.
| | - Jacqueline Coral Kent
- School of Molecular Sciences, The University of Western Australia, Perth, Western Australia, Australia.
| | - Ching Tat Lai
- School of Molecular Sciences, The University of Western Australia, Perth, Western Australia, Australia.
| | - Alethea Rea
- Faculty of Engineering and Mathematical Sciences, Mathematics and Statistics, The University of Western Australia, Perth, Western Australia, Australia; College of Science, Health, Engineering and Education, Academic Operations, Information Technology, Mathematics and Statistics, Murdoch University, Perth, Western Australia, Australia.
| | - Anna Rachel Hepworth
- School of Molecular Sciences, The University of Western Australia, Perth, Western Australia, Australia.
| | - Kevin Murray
- School of Population and Global Health, The University of Western Australia, Perth, Western Australia, Australia.
| | - Donna Tracy Geddes
- School of Molecular Sciences, The University of Western Australia, Perth, Western Australia, Australia.
| |
Collapse
|
3
|
Capponi I, Roland F. Relationship between emotional labelling of breastfeeding situation and intention to breastfeed/support breastfeeding among French adolescents and young people. J Public Health (Oxf) 2021. [DOI: 10.1007/s10389-019-01037-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
|
4
|
Compensatory Health Beliefs on Breastfeeding Varying by Breastfeeding Status; A Scale Development. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17165759. [PMID: 32784938 PMCID: PMC7460425 DOI: 10.3390/ijerph17165759] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/09/2020] [Revised: 08/02/2020] [Accepted: 08/07/2020] [Indexed: 11/17/2022]
Abstract
AIMS To examine whether compensatory health beliefs (CHB) on breastfeeding vary as a function of breastfeeding status among mothers of infants. METHODS Participants included 773 women aged 18 and older (M = 32.8) who gave birth in the last two years; 445 were breastfeeding exclusively, 165 were breastfeeding partially, and 163 were not breastfeeding. They responded to a survey posted on social media sites' closed groups that focused on post-natal issues. Design was cross-sectional, with CHB as the outcome variable (14 items) and demographics and feeding status as the explanatory variables. RESULTS The internal reliability of the CHB scale was α = 0.87. There was a statistically significant difference in the level of CHB between non-breastfeeding women, breastfeeding women, and women who combined breastfeeding with infant formula, so that non- breastfeeding women had the highest level of CHB. There was no significant difference in CHB by either birth experience or demographic characteristics. CONCLUSION This study extended CHB to breastfeeding, documenting the minimization of the disadvantages of not breastfeeding by non-breastfeeding women, attempting to neutralize or reduce the cognitive dissonance between non-nursing and optimal infant care. Possible uses of the scale for counselling were suggested, both in the prenatal and post-natal period, proactively bringing forward and addressing ambivalence towards breastfeeding.
Collapse
|
5
|
Mathias JG, Zhang H, Soto-Ramirez N, Karmaus W. The association of infant feeding patterns with food allergy symptoms and food allergy in early childhood. Int Breastfeed J 2019; 14:43. [PMID: 31666803 PMCID: PMC6813109 DOI: 10.1186/s13006-019-0241-x] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2019] [Accepted: 10/10/2019] [Indexed: 12/12/2022] Open
Abstract
Background The role of infant feeding for food allergy in children is unclear and studies have not addressed simultaneous exposures to different foods. The goal of this study was to analyze existing data on feeding practices that represent realistic exposure and assess the risk of food allergy symptoms and food allergy in children. Methods The Infant Feeding Practices Study II conducted by the CDC and US-FDA enrolled pregnant women and collected infant feeding information using nine repeated surveys. Participants were re-contacted after 6 years. Food allergy data were collected at 4, 9, 12, and 72 months. In total, 1387 participants had complete infant feeding pattern data for 6 months and information on food allergy symptoms and doctors’ diagnosed food allergy. Feeding patterns constituted six groups: 3-months of feeding at breast followed by mixed feeding, 3-months of breast milk and bottled milk followed by mixed feeding, 1-month of feeding at breast followed by mixed feeding, 6-months of mixed feeding i.e., concurrent feeding of breast milk, bottled milk and formula, 2–3 months of formula followed by formula and solid food, and formula and solid food since the first month. To estimate risks of food allergy, we used linear mixed models, controlling for potential confounders. Results Of the 328 children with food allergy symptoms in infancy and at 6 years, 52 had persistent symptoms from infancy. Children exposed to mixed feeding had a higher risk of food allergy symptoms (Risk Ratio [RR] 1.54; 95% Confidence Interval [CI] 1.04, 2.29) compared to 3-months of feeding at breast adjusted for confounding. No statistically significant risk of infant feeding patterns was found for doctors’ diagnosed food allergy. Paternal allergy posed a higher risk for food allergy symptoms (RR 1.36; 95% CI 1.01, 1.83). Prenatal maternal smoking increased the risk for doctors’ diagnosed food allergy (RR 2.97; 95% CI 1.53, 5.79). Conclusions Analysis of this prospective birth cohort suggest that introduction of multiple feeding source may lead to food allergy symptoms. Future efforts are needed to determine acceptable approaches to improve the ascertainment of food allergy in children and the role of infant feeding.
Collapse
Affiliation(s)
- Joacy G Mathias
- 1Division of Epidemiology, Biostatistics, and Environmental Health, School of Public Health, The University of Memphis, Memphis, TN USA
| | - Hongmei Zhang
- 1Division of Epidemiology, Biostatistics, and Environmental Health, School of Public Health, The University of Memphis, Memphis, TN USA
| | | | - Wilfried Karmaus
- 1Division of Epidemiology, Biostatistics, and Environmental Health, School of Public Health, The University of Memphis, Memphis, TN USA
| |
Collapse
|
6
|
Abdulahi M, Fretheim A, Magnus JH. Effect of breastfeeding education and support intervention (BFESI) versus routine care on timely initiation and exclusive breastfeeding in Southwest Ethiopia: study protocol for a cluster randomized controlled trial. BMC Pediatr 2018; 18:313. [PMID: 30257661 PMCID: PMC6158863 DOI: 10.1186/s12887-018-1278-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/01/2018] [Accepted: 09/05/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Infant mortality rates are still high in Ethiopia. Breastfeeding is regarded as the simplest and least expensive strategy for reduction of infant mortality rates. Community-based educational and support interventions provided prenatally and postnatally are effective in increasing breastfeeding rates. However, such interventions are not widely implemented in Ethiopia. This study aims to assess the effect of breastfeeding education and support on timely initiation and duration of exclusive breastfeeding. METHODS A cluster-randomized controlled trial at the community level will be conducted to compare the effect of breastfeeding education and support versus routine care. The intervention will be provided by Women Development Army leaders who are already in the country's health system using a 40-h WHO breastfeeding counseling course, "Infant and Young Child Feeding Counseling: an integrated course" and the "Training of Trainers Manual for Counseling on Maternal, Infant and Young Child Nutrition" in the local language. Culturally appropriate operational packages of information will be developed for them. Using preset criteria at least 432 pregnant women in their third trimester will be recruited from 36 zones. Visits in the intervention arm include two prenatal visits and 8 postnatal visits. Supervisory visits will be conducted monthly to each intervention zone. Data will be entered into Epi-data version 3.1 and analyzed using STATA version 13.0. All analysis will be done by intention to treat analysis. We will fit mixed-effects linear regression models for the continuous outcomes and mixed-effects linear probability models for the binary outcomes with study zone as random intercept to estimate study arm difference (intervention vs. routine education) adjusted for baseline value of the outcome and additional relevant covariates. The protocol was developed in collaboration with the Jimma Zone and Mana district Health office. Ethical clearance was obtained from the Institutional Review Board of University of Oslo and Jimma University. This study is partly funded by NORAD's NORHED programme. DISCUSSION We expect that the trial will generate findings that can inform breastfeeding policies and practices in Ethiopia. TRIAL REGISTRATION ClinicalTrials.gov NCT 03030651 January 25, 2017 version 3 dated 16 July 2018.
Collapse
Affiliation(s)
- Misra Abdulahi
- Department of Population and Family Health, Jimma University, Jimma, Ethiopia
- Department of Community Medicine and Global Health, University of Oslo, Oslo, Norway
| | - Atle Fretheim
- Department of Community Medicine and Global Health, University of Oslo, Oslo, Norway
- Norwegian Institute of Public Health, Oslo, Norway
| | - Jeanette H. Magnus
- Faculty of Medicine, University of Oslo, Oslo, Norway
- Department of Global Community Health and Behavioral Sciences, Tulane School of Public Health and Tropical Medicine, New Orleans, USA
| |
Collapse
|
7
|
Public Health: The Intersection of Food Security and Well-being. JOURNAL OF PUBLIC HEALTH MANAGEMENT AND PRACTICE 2018. [PMID: 29521853 DOI: 10.1097/phh.0000000000000779] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
8
|
Suboptimal infant and young child feeding practices among internally displaced persons during conflict in eastern Ukraine. Public Health Nutr 2017; 21:917-926. [PMID: 29268805 PMCID: PMC5848760 DOI: 10.1017/s1368980017003421] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE To determine current status, areas for improvement and effect of conflict on infant and young child feeding (IYCF) practices among internally displaced persons (IDP) in eastern Ukraine. DESIGN Cross-sectional household survey, June 2015. SETTING Kharkiv, Dnipropetrovsk and Zaporizhia oblasts (Ukrainian administrative divisions) bordering conflict area in Ukraine. SUBJECTS Randomly selected IDP households with children aged <2 years registered with local non-governmental organizations. Questions based on the WHO IYCF assessment questionnaire were asked for 477 children. Mid-upper arm circumference was measured in 411 children aged 6-23 months. RESULTS Exclusive breast-feeding prevalence for infants aged <6 months was 25·8 (95 % CI 15·8, 38·0) %. Percentage of mothers continuing breast-feeding when their child was aged 1 and 2 years was 53·5 (95 % CI 43·2, 63·6) % and 20·6 (95 % CI 11·5, 32·7) %, respectively. Bottle-feeding was common for children aged <2 years (68·1 %; 95 % CI 63·7, 72·3 %). Almost all infants aged 6-8 months received solid foods (98·6 %; 95 % CI 88·5, 99·9 %). Mothers who discontinued breast-feeding before their infant was 6 months old more often listed stress related to conflict as their primary reason for discontinuation (45·7 %) compared with mothers who discontinued breast-feeding when their child was aged 6-23 months (14·3 %; P<0·0001). CONCLUSIONS To mitigate the effects of conflict and improve child health, humanitarian action is needed focused on helping mothers cope with stress related to conflict and displacement while supporting women to adhere to recommended IYCF practices if possible and providing appropriate support to women when adherence is not feasible.
Collapse
|
9
|
Dritsakou K, Liosis G, Valsami G, Polychronopoulos E, Souliotis K, Skouroliakou M. Mother's breast milk supplemented with donor milk reduces hospital and health service usage costs in low-birthweight infants. Midwifery 2016; 40:109-13. [PMID: 27428106 DOI: 10.1016/j.midw.2016.06.015] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2015] [Revised: 03/19/2016] [Accepted: 06/22/2016] [Indexed: 10/21/2022]
Abstract
OBJECTIVE to compare hospital and health service usage costs of feeding low-birthweight (LBW) infants predominantly with their mother's milk, supplemented with donor milk, with donor milk and preterm formula. DESIGN prospective matching study. SETTING tertiary public perinatal centre, neonatal intensive care unit (NICU) and donor human milk bank. PARTICIPANTS 100LBW infants (Group I) fed predominantly with their mother's milk from the first hour of life, supplemented (mainly for the first week of life) with donor milk, were matched on a 1:1 basis with 100LBW infants (Group II) who were fed with donor milk for the first 3 weeks of life followed by preterm formula until hospital discharge. Individualised targeted fortification of human milk was implemented in both study groups. FINDINGS the costs of hospitalisation, doctor visits and prescription drugs for viral infections until 8 months of age were calculated for each infant. Infants fed predominantly with their mother's milk had significantly shorter hospital stays and lower hospitalisation costs. In Group I infants, the duration of enteral gavage feeding was shorter, resulting in significantly lower costs. Up to 8 months of age, Group I infants experienced fewer episodes of viral infections, and the cost of each doctor visit and drug prescription was lower for these infants. CONCLUSIONS feeding LBW infants predominantly with their mother's milk reduces hospital and health service usage costs. IMPLICATIONS FOR PRACTICE feeding LBW infants predominantly with their mother's milk, supplemented with donor milk, followed by exclusive breast feeding seems to result in potential savings in hospital and health service usage costs.
Collapse
Affiliation(s)
- Kalliopi Dritsakou
- Departments of Quality Control, Research and Continuing Education, Elena Venizelou Maternity Hospital, Athens, Greece.
| | - Georgios Liosis
- Human Milk Bank, Elena Venizelou Maternity Hospital, Athens, Greece
| | | | | | | | - Maria Skouroliakou
- Department of Science of Dietetics-Nutrition, Harokopeion University of Athens, Athens, Greece
| |
Collapse
|
10
|
Marques RFSV, Taddei JAAC, Lopez FA, Braga JAP. Breastfeeding exclusively and iron deficiency anemia during the first 6 months of age. Rev Assoc Med Bras (1992) 2015; 60:18-22. [PMID: 24918847 DOI: 10.1590/1806-9282.60.01.006] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2012] [Accepted: 08/07/2013] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE The objective was to determine the prevalence of iron deficiency and iron deficiency anemia among exclusively breastfed infants from one to six months of life and to identify associated risk factors. METHODS This is a cohort study of the hemoglobin and serum ferritin levels of 102 healthy full-term infants, weighing more than 2500 grams (5.5 pounds) at birth, evaluated for growth development and supported to promote exclusive breastfeeding. Hemoglobin and ferritin levels were measured in the first, fourth, and sixth months of life. The hemoglobin and ferritin levels of the mothers were also measured in the first month postpartum. RESULTS At four months, 5.7% presented iron deficiency and 3.4% had iron deficiency anemia. At six months, the percentage of children with iron deficiency increased more than four times, reaching 26.1%, while iron deficiency anemia was present in 23.9% of the infants studied. Iron deficiency at six months of age was significantly correlated to growth velocity. CONCLUSION According to the results of this study, exclusive breastfeeding protects infants from iron deficiency and iron deficiency anemia for the first four months of life. After this age, in accordance with the literature, the findings of this study demonstrated an increase in anemia and iron deficiency rates, adding to evidence that supports the monitoring of iron levels in exclusively breastfed children presenting higher weight gains beginning at four months of age.
Collapse
Affiliation(s)
- Rosa F S V Marques
- Pediatrician, Professor, Department of Integral Health, State University of Pará, Pará, Brazil
| | - José A A C Taddei
- Associate Professor, Department of Pediatrics, Escola Paulista de Medicina, Federal University of São Paulo, São Paulo, SP, Brazil
| | - Fábio A Lopez
- Full Professor, Department of Pediatrics, Escola Paulista de Medicina, Federal University of São Paulo, São Paulo, SP, Brazil
| | - Josefina A P Braga
- Adjunt Professor, Department of Pediatrics, Escola Paulista de Medicina, Federal University of São Paulo, São Paulo, SP, Brazil
| |
Collapse
|
11
|
Breakey AA, Hinde K, Valeggia CR, Sinofsky A, Ellison PT. Illness in breastfeeding infants relates to concentration of lactoferrin and secretory Immunoglobulin A in mother's milk. EVOLUTION MEDICINE AND PUBLIC HEALTH 2015; 2015:21-31. [PMID: 25608691 PMCID: PMC4334701 DOI: 10.1093/emph/eov002] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
BACKGROUND AND OBJECTIVES This study aims to better understand the relationship between immune compounds in human milk and infant health. We hypothesized that the concentration of immune compounds in milk would relate to infant illness symptoms according to two possible theoretical paradigms. In the 'protective' paradigm, high concentrations of immune compounds prevent infant illness. The converse, the 'responsive' framework, posits that concentrations of immune compounds are elevated in response to infection. METHODOLOGY Milk samples (n = 110) and illness data were collected among the Toba of Argentina from 30 mother-infant dyads. Samples were assayed for two immune proteins, lactoferrin and secretory immunoglobulin A (sIgA). Generalized estimating equations were used to assess the relationship between immune composition of milk and symptoms of illness in infants. RESULTS Lactoferrin was positively associated with symptoms of illness in infants (odds ratios >1), both in the month preceding the sample collection and the subsequent month. sIgA was negatively associated with symptoms (odds ratios <1) in the preceding and subsequent months, an association which was particularly strong for gastrointestinal symptoms. CONCLUSIONS AND IMPLICATIONS The two compounds investigated in our study had opposite relationships with symptoms of illness; the positive relationship between lactoferrin and illness lends support to our 'responsive' paradigm, and the negative relationship between sIgA and symptoms of illness was consistent with our 'protective' framework. That elevated lactoferrin is restricted to periods of illness suggests that there may be a cost to mother or infant associated with persistently elevated lactoferrin that is not incurred with elevated sIgA.
Collapse
Affiliation(s)
- Alicia A Breakey
- Department of Human Evolutionary Biology, Harvard University, Cambridge MA 02138, USA, Department of Anthropology, Yale University, 10 Sachem St., New Haven CT 06511, USA
| | - Katie Hinde
- Department of Human Evolutionary Biology, Harvard University, Cambridge MA 02138, USA, Department of Anthropology, Yale University, 10 Sachem St., New Haven CT 06511, USA
| | - Claudia R Valeggia
- Department of Human Evolutionary Biology, Harvard University, Cambridge MA 02138, USA, Department of Anthropology, Yale University, 10 Sachem St., New Haven CT 06511, USA
| | - Allison Sinofsky
- Department of Human Evolutionary Biology, Harvard University, Cambridge MA 02138, USA, Department of Anthropology, Yale University, 10 Sachem St., New Haven CT 06511, USA
| | - Peter T Ellison
- Department of Human Evolutionary Biology, Harvard University, Cambridge MA 02138, USA, Department of Anthropology, Yale University, 10 Sachem St., New Haven CT 06511, USA
| |
Collapse
|
12
|
Esteves TMB, Daumas RP, de Oliveira MIC, de Andrade CADF, Leite IC. Factors associated to breastfeeding in the first hour of life: systematic review. Rev Saude Publica 2014; 48:697-708. [PMID: 25210829 PMCID: PMC4181097 DOI: 10.1590/s0034-8910.2014048005278] [Citation(s) in RCA: 77] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2013] [Accepted: 03/07/2014] [Indexed: 12/29/2022] Open
Abstract
OBJECTIVE To identify independent risk factors for non-breastfeeding within the first hour of life. METHODS A systematic review of Medline, LILACS, Scopus, and Web of Science electronic databases, till August 30, 2013, was performed without restrictions on language or date of publishing. Studies that used regression models and provided adjusted measures of association were included. Studies in which the regression model was not specified or those based on specific populations regarding age or the presence of morbidities were excluded. RESULTS The search resulted in 155 articles, from which 18 met the inclusion criteria. These were conducted in Asia (9), Africa (5), and South America (4), between 1999 and 2013. The prevalence of breastfeeding within the first hour of life ranged from 11.4%, in a province of Saudi Arabia, to 83.3% in Sri Lanka. Cesarean delivery was the most consistent risk factor for non-breastfeeding within the first hour of life. "Low family income", "maternal age less than 25 years", "low maternal education", "no prenatal visit", "home delivery", "no prenatal guidance on breastfeeding" and "preterm birth" were reported as risk factors in at least two studies. CONCLUSIONS Besides the hospital routines, indicators for low socioeconomic status and poor access to health services were also identified as independent risk factors for non-breastfeeding within the first hour of life. Policies to promote breastfeeding, appropriate to each context, should aim to reduce inequalities in health.
Collapse
Affiliation(s)
- Tania Maria Brasil Esteves
- Centro de Saúde Escola Germano Sinval Faria, Escola Nacional de Saúde Pública Sergio Arouca, Fundação Oswaldo Cruz, Rio de Janeiro, RJ, Brasil, Centro de Saúde Escola Germano Sinval Faria. Escola Nacional de Saúde Pública Sergio Arouca. Fundação Oswaldo Cruz. Rio de Janeiro, RJ, Brasil
| | - Regina Paiva Daumas
- Centro de Saúde Escola Germano Sinval Faria, Escola Nacional de Saúde Pública Sergio Arouca, Fundação Oswaldo Cruz, Rio de Janeiro, RJ, Brasil, Centro de Saúde Escola Germano Sinval Faria. Escola Nacional de Saúde Pública Sergio Arouca. Fundação Oswaldo Cruz. Rio de Janeiro, RJ, Brasil
| | - Maria Inês Couto de Oliveira
- Departamento de Epidemiologia e Bioestatística, Instituto de Saúde da Comunidade, Universidade Federal Fluminense, Niterói, RJ, Brasil, Departamento de Epidemiologia e Bioestatística. Instituto de Saúde da Comunidade. Universidade Federal Fluminense. Niterói, RJ, Brasil
| | - Carlos Augusto de Ferreira de Andrade
- Laboratório de Epidemiologia Clínica, Instituto de Pesquisa Clínica Evandro Chagas, Fundação Oswaldo Cruz, Rio de Janeiro, RJ, Brasil, Laboratório de Epidemiologia Clínica. Instituto de Pesquisa Clínica Evandro Chagas. Fundação Oswaldo Cruz. Rio de Janeiro, RJ, Brasil
| | - Iuri Costa Leite
- Departamento de Epidemiologia e Métodos Quantitativos, Escola Nacional de Saúde Pública Sergio Arouca, Fundação Oswaldo Cruz, Rio de Janeiro, RJ, Brasil, Departamento de Epidemiologia e Métodos Quantitativos. Escola Nacional de Saúde Pública Sergio Arouca. Fundação Oswaldo Cruz. Rio de Janeiro, RJ, Brasil
| |
Collapse
|
13
|
|
14
|
Smith J, Blake M. Infant food marketing strategies undermine effective regulation of breast-milk substitutes: trends in print advertising in Australia, 1950-2010. Aust N Z J Public Health 2014; 37:337-44. [PMID: 23895476 DOI: 10.1111/1753-6405.12081] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
OBJECTIVE This study addresses the issue of whether voluntary industry regulation has altered companies' marketing of breast-milk substitutes in Australia since the adoption of the World Health Organization (WHO) International Code on the Marketing of Breast-milk Substitutes 1981. METHODS Print advertisements marketing breast-milk substitutes were systematically sampled from the Australian Women's Weekly (AWW) magazine and the Medical Journal of Australia (MJA) for the 61 years from 1950 to 2010. RESULTS Breast-milk substitute advertising in both the MJA and the AWW peaked and began declining before the introduction of the WHO Code in 1981. Although there was almost no infant formula advertising in AWW after 1975-79, other breast-milk substitute advertising has been increasing since 1992, in particular for baby food, toddler formula and food and brand promotion. CONCLUSIONS Companies have adopted strategies to minimise the effects of the Code on sales and profit in Australia, including increasing toddler formula and food advertisements, increasing brand promotion to the public, and complying with more limited voluntary regulatory arrangements. IMPLICATIONS Comprehensive regulation is urgently required to address changed marketing practices if it is to protect breastfeeding in Australia.
Collapse
Affiliation(s)
- Julie Smith
- Australian Centre for Economic Research on Health, College of Medicine, Biology and Environment, The Australian National University, ACT, Australia.
| | | |
Collapse
|
15
|
Giles M, Millar S, Armour C, McClenahan C, Mallett J, Stewart-Knox B. Promoting positive attitudes to breastfeeding: the development and evaluation of a theory-based intervention with school children involving a cluster randomised controlled trial. MATERNAL AND CHILD NUTRITION 2013; 11:656-72. [PMID: 24028173 DOI: 10.1111/mcn.12079] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
The objective of this study was to design, implement and evaluate an intervention based on the theory of planned behaviour (TPB) to enhance young peoples' motivations to breastfeed/support a partner to breastfeed. Six semi-structured focus groups were first conducted with 48 13-14-year-olds from two schools in Northern Ireland. The salient beliefs elicited were subsequently used to design a TPB-based questionnaire that was then administered to 2021 13-14-year-old pupils (852 males; 1169 females) from 36 post-primary schools to identify the most important determinants of breastfeeding. The results were used to inform the design and implementation of an intervention package that was subsequently evaluated using a cluster randomised controlled trial involving 44 randomly selected schools across Northern Ireland. Questionnaires were administered to 18 intervention and 26 control schools at baseline and again at 1 and 6 months post-intervention to evaluate its effectiveness. Multi-level modelling was employed to analyse the data. The results revealed significant effects on women's intention to breastfeed, β = 0.208, t(1275) = 2.715, P = 0.007; attitudes, β = 0.223, t(1275) = 4.655, P < 0.001; moral attitudes, β = 0.231, t(1275) = 4.211, P < 0.001; subjective norm, β = 0.118, t(1275) = 2.521, P = 0.012; and knowledge, β = 0.109, d.f. (1275) = 7.843, P < 0.001. However, for men, the results revealed significant effects on only the construct of knowledge, β = 0.104, t(541) = 4.345, P < 0.001.The research has provided evidence to support the need for breastfeeding education in schools and has shown how a theoretical framework may be used to inform the design and evaluation of a health behaviour intervention.
Collapse
Affiliation(s)
- Melanie Giles
- School of Psychology, University of Ulster, Coleraine, UK
| | - Samantha Millar
- UKCRC Centre of Excellence for Public Health NI, Institute of Clinical Sciences, School of Medicine, Dentistry and Biomedical Sciences, Queens University, Belfast, UK
| | - Cherie Armour
- School of Psychology, University of Ulster, Coleraine, UK
| | | | - John Mallett
- School of Psychology, University of Ulster, Coleraine, UK
| | | |
Collapse
|
16
|
Affiliation(s)
- Mahmoud A Mohammad
- Department of Pediatrics, Children’s Nutrition Research Center, U.S. Department of Agriculture/Agricultural Research Service, Baylor College of Medicine, Houston, Texas, USA.
| | | |
Collapse
|
17
|
Hayatbakhsh MR, O'Callaghan MJ, Bor W, Williams GM, Najman JM. Association of breastfeeding and adolescents' psychopathology: a large prospective study. Breastfeed Med 2012; 7:480-6. [PMID: 22612623 DOI: 10.1089/bfm.2011.0136] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
PURPOSE There is little known about the association between breastfeeding and long-term child psychopathology. This study aimed to examine the impact of breastfeeding on child mental health and problem behavior at 14 years and whether this association is confounded by other variables. SUBJECTS AND METHODS Data were from a pre-birth prospective study that included mothers and their children followed up from pregnancy to 14 years of the child's age in Brisbane, Australia. The child's anxiety/depression, withdrawal problems, somatic complaints, social problems, thought problems, attention problems, aggression, and delinquency were measured using the Achenbach Youth Self Report at 14 years. Breastfeeding was prospectively assessed at the 6-month follow-up of the study. The analysis was based on 4,502 adolescents who responded to the YSR questionnaire and for whom prospective data were available on breastfeeding. RESULTS Breastfeeding as reported by mothers when the child was 6 months old predicted reduced symptoms of child mental health and problem behavior at 14 years. The impact of breastfeeding on the child's social problems, attention problems, and aggressive behavior remained statistically significant after controlling for the effect of other variables, such as unplanned pregnancy, maternal mental health, and substance use during pregnancy. CONCLUSIONS Our data suggest that breastfeeding for at least 4 months can have a significant protective effect on a child's social, attention, and aggression problems in early adolescence. Given the limitations of the existing evidence, further research is needed to investigate the robustness of the findings of this study and the mechanisms of long-term association between breastfeeding and reduced social, attention, and aggression problems of the offspring in adolescence.
Collapse
Affiliation(s)
- Mohammad R Hayatbakhsh
- School of Population Health, The University of Queensland, Herston, Queensland, Australia
| | | | | | | | | |
Collapse
|
18
|
Lawton R, Ashley L, Dawson S, Waiblinger D, Conner M. Employing an extended Theory of Planned Behaviour to predict breastfeeding intention, initiation, and maintenance in White British and South-Asian mothers living in Bradford. Br J Health Psychol 2012; 17:854-71. [DOI: 10.1111/j.2044-8287.2012.02083.x] [Citation(s) in RCA: 50] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
|
19
|
Chinkonde JR, Hem MH, Sundby J. HIV and infant feeding in Malawi: public health simplicity in complex social and cultural contexts. BMC Public Health 2012; 12:700. [PMID: 22925437 PMCID: PMC3489588 DOI: 10.1186/1471-2458-12-700] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2012] [Accepted: 08/23/2012] [Indexed: 11/16/2022] Open
Abstract
Background The question of when and how to best wean infants born to mothers with HIV requires complex answers. There are clinical guidelines on best approaches but limitations persist when applying them in diverse low-income settings. In such settings, infant-feeding practices are not only dependent on individual women’s choices but are also subject to social and cultural pressures. However, when developing infant-feeding policies little attention has been paid to these pressures, even though they may yield useful empirical knowledge on the various forces that shape the infant-feeding dilemmas confronting women with HIV. This study aimed to a) identify the infant-feeding challenges that women with HIV faced when they were advised to wean their children at an early age of six months and b) explore how the women adhered to their infant-feeding options while facing and managing these challenges. Methods This study was conducted between February 2008 and April 2009 at two public health facilities where services to prevent mother-to-child transmission of HIV were implemented. Repeated in-depth interviews were conducted with 20 HIV-positive women. Two of the 20 women were also chosen for case studies which included home visits. Results Several interdependent factors including the conflicting pressures of sexual morality and the demands of nurturing and motherhood, in conditions of abject poverty, impeded the participating women from following medical advice on infant feeding. If they adhered to the medical advice, the women would encounter difficulty maintaining their ascribed roles as respected wives, mothers and members of the society at large. The necessity of upholding their moral standing through continued breastfeeding, which signified HIV-negative status, put pressure on them to ignore the medical advice. Conclusions The infant-feeding dilemmas for women with HIV are complex. The integration of public health efforts with context-specific socio-cultural understanding is essential. The recent 2010 WHO guidelines offer a possible way of resolving these challenges. They recommend breastfeeding for one year with an adaptation to two years for Malawi. Efforts in the PMTCT programmes to supplement existing support systems, e.g. through the mothers-to-mothers (M2M) programme or consultation with expert mothers may also help women overcome these challenges.
Collapse
Affiliation(s)
- Jacqueline R Chinkonde
- Institute of Health and Society, Department of Community Medicine, University of Oslo, Lilongwe, Norway.
| | | | | |
Collapse
|
20
|
Mangasaryan N, Martin L, Brownlee A, Ogunlade A, Rudert C, Cai X. Breastfeeding promotion, support and protection: review of six country programmes. Nutrients 2012; 4:990-1014. [PMID: 23016128 PMCID: PMC3448083 DOI: 10.3390/nu4080990] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2012] [Revised: 07/24/2012] [Accepted: 08/02/2012] [Indexed: 11/16/2022] Open
Abstract
Reviews of programmes in Bangladesh, Benin, the Philippines, Sri Lanka, Uganda, and Uzbekistan sought to identify health policy and programmatic factors that influenced breastfeeding practices during a 10 to 15 year period. Exclusive breastfeeding rates and trends were analysed in six countries in general and from an equity perspective in two of them. Success factors and challenges were identified in countries with improved and stagnated rates respectively. The disaggregated data analysis showed that progress may be unequal in population subgroups, but if appropriately designed and implemented, a programme can become a "health equalizer" and eliminate discrepancies among different subgroups. Success requires commitment, supportive policies, and comprehensiveness of programmes for breastfeeding promotion, protection and support. Community-based promotion and support was identified as a particularly important component. Although health workers' training on infant feeding support and counselling was prioritized, further improvement of interpersonal counselling and problem solving skills is needed. More attention is advised for pre-service education, including a stronger focus on clinical practice, to ensure knowledge and skills among all health workers. Large-scale communication activities played a significant role, but essential steps were often underemphasized, including identifying social norms and influencing factors, ensuring community participation, and testing of approaches and messages.
Collapse
Affiliation(s)
- Nune Mangasaryan
- United Nations Children’s Fund, 3 United Nations Plaza, New York, NY 10017, USA; (A.O.); (C.R.); (X.C.)
| | | | - Ann Brownlee
- School of Medicine, University of California, San Diego, CA 92093, USA;
| | - Adebayo Ogunlade
- United Nations Children’s Fund, 3 United Nations Plaza, New York, NY 10017, USA; (A.O.); (C.R.); (X.C.)
| | - Christiane Rudert
- United Nations Children’s Fund, 3 United Nations Plaza, New York, NY 10017, USA; (A.O.); (C.R.); (X.C.)
| | - Xiaodong Cai
- United Nations Children’s Fund, 3 United Nations Plaza, New York, NY 10017, USA; (A.O.); (C.R.); (X.C.)
| |
Collapse
|
21
|
Evolutionary medicine: Bottle feeding, birth spacing, and autism. Med Hypotheses 2011; 77:345-6. [DOI: 10.1016/j.mehy.2011.05.010] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2011] [Accepted: 05/09/2011] [Indexed: 11/18/2022]
|
22
|
Fiese BH, Gundersen C, Koester B, Washington L. Household Food Insecurity: Serious Concerns for Child Development and commentaries. ACTA ACUST UNITED AC 2011. [DOI: 10.1002/j.2379-3988.2011.tb00068.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
|
23
|
Tan KL. Factors associated with exclusive breastfeeding among infants under six months of age in peninsular malaysia. Int Breastfeed J 2011; 6:2. [PMID: 21284889 PMCID: PMC3039569 DOI: 10.1186/1746-4358-6-2] [Citation(s) in RCA: 111] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2010] [Accepted: 02/02/2011] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND Breastfeeding is accepted as the natural form of infant feeding. For mothers to be able to breastfeed exclusively to the recommended six months, it is important to understand the factors that influence exclusive breastfeeding. The aim of the study was to identify factors associated with exclusive breastfeeding in Peninsular Malaysia. METHODS This was a cross-sectional study involving 682 mother-infant pairs with infants up to six months attending maternal and child health section of the government health clinics in Klang, Malaysia. Data were collected by face-to-face interviews using a pre-tested structured questionnaire over 4 months in 2006. Data on breastfeeding were based on practice in the previous one month period. Logistic regression was used to assess the independent association between the independent variables and exclusive breastfeeding adjusting for infant age. RESULTS The prevalence of exclusive breastfeeding among mothers with infants aged between one and six months was 43.1% (95% CI: 39.4, 46.8). In the multivariate model exclusive breastfeeding was positively associated with rural residence, Malay mothers, non-working and non-smoking mothers, multiparous mothers, term infants, mothers with husbands who support breastfeeding and mothers who practice bed-sharing. CONCLUSIONS Interventions that seek to increase exclusive breastfeeding should focus on women who are at risk of early discontinuation of breastfeeding.
Collapse
Affiliation(s)
- Kok Leong Tan
- Community Medicine Division, International Medical University, Bukit Jalil, 57000 Kuala Lumpur, Malaysia.
| |
Collapse
|
24
|
Lee R, Schwartz RA. Human T-lymphotrophic virus type 1–associated infective dermatitis: A comprehensive review. J Am Acad Dermatol 2011; 64:152-60. [DOI: 10.1016/j.jaad.2009.10.021] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2009] [Revised: 10/09/2009] [Accepted: 10/10/2009] [Indexed: 12/31/2022]
|
25
|
McMillan B, Conner M, Green J, Dyson L, Renfrew M, Woolridge M. Using an extended theory of planned behaviour to inform interventions aimed at increasing breastfeeding uptake in primiparas experiencing material deprivation. Br J Health Psychol 2010; 14:379-403. [DOI: 10.1348/135910708x336112] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
|
26
|
Aksu H, Küçük M, Düzgün G. The effect of postnatal breastfeeding education/support offered at home 3 days after delivery on breastfeeding duration and knowledge: a randomized trial. J Matern Fetal Neonatal Med 2010; 24:354-61. [PMID: 20608806 DOI: 10.3109/14767058.2010.497569] [Citation(s) in RCA: 60] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE The aim of this study was to determine the effects of breastfeeding education/support offered at home on day 3 postpartum on breastfeeding duration and knowledge. METHODS The study included a total of 60 women who gave birth at Zübeyde Hanım Maternity Hospital located in Aydın, Turkey. In addition to a standard breastfeeding education in the first few hours after delivery, which was provided to all women in this "baby-friendly initiative" (BFI) hospital, the mothers in the intervention group received breastfeeding education at home on day 3 postpartum from supporters. RESULTS Both groups were comparable in terms of maternal and neonatal characteristics. The breastfeeding education/support offered during a home visit on day 3 postpartum was associated with a significant increase in the percentage of exclusively breastfed infants both at 2 weeks and 6 weeks, and at 6 months, and was also associated with a significant increase in exclusive breastfeeding and in total breastfeeding duration. In addition, increased breastfeeding knowledge scores were observed in the intervention group at 2 weeks and at 6 weeks after delivery, when compared with the respective scores in the control group. CONCLUSION Breastfeeding education offered at home on day 3 postpartum was effective in increasing the breastfeeding duration and breastfeeding knowledge.
Collapse
Affiliation(s)
- Hilmiye Aksu
- Obstetrics and Gynecology Nursing Department, Aydın School for Health Sciences, Adnan Menderes University, Aydın, Turkey
| | | | | |
Collapse
|
27
|
Ijarotimi OS. Assessing exclusive breastfeeding practices, dietary intakes and body mass index (BMI) of nursing mothers in Ekiti State of Nigeria. Nutr Res Pract 2010; 4:222-8. [PMID: 20607068 PMCID: PMC2895703 DOI: 10.4162/nrp.2010.4.3.222] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2010] [Revised: 06/11/2010] [Accepted: 06/11/2010] [Indexed: 11/04/2022] Open
Abstract
Breastfeeding is an unequalled way of providing ideal food for the infants. The benefits of breastfeeding practices to infants and mothers are well documented. However, information on breastfeeding practices and its effect on body mass index (BMI) of mothers are scarce, particularly in Ekiti State of Nigeria. Therefore, the present study is designed to assess breastfeeding practices and its association with BMI of mothers. A descriptive and cross-sectional study was conducted among breastfeeding mothers that attended postnatal clinic of the state specialist hospitals and maternity centers in the study location. The specialist hospital and two-third of the nine maternity centers were purposively selected because of their health facilities and personnel. The mother-child pairs (200 respondents) were randomly selected from the study locations. Information on demographic characteristic, socio-economic parameters, nutritional knowledge of breastfeeding and dietary intakes of mothers were collected using questionnaires. BMI of mothers was determined as described by World Health Organization. Age distribution of mothers was between 25-34 years; and almost half of respondents had good educational background and were engaged in different occupations. The respondent monthly income ranged between = N = 3500 - 26000 ($26.92 - $200); and their dietary intakes varied between starchy and protein-based food. The result also showed that the respondent consumed enough nutrients to meet up the recommended daily allowance for protein, carbohydrate, fat, zinc, magnesium, sodium and phosphorous requirements. The BMI classifications showed that over three-fifth of respondents were normal, while the remaining were underweight (6%) and overweight/obese (26.5%). Also, large proportion of respondents engaged in exclusive breastfeeding and with good knowledge of breastfeeding practices. Statistically, exclusive breastfeeding practices had no correlation between the BMI and frequency of breastfeeding. The study, therefore, concluded that mothers had good knowledge of breastfeeding practice; and that there was no association between breastfeeding practices and BMI.
Collapse
Affiliation(s)
- Oluwole Steve Ijarotimi
- Department of Food Science and Technology, Federal University of Technology, Akure, Ondo State, Nigeria
| |
Collapse
|
28
|
Ziol-Guest KM, Hernandez DC. First- and second-trimester WIC participation is associated with lower rates of breastfeeding and early introduction of cow's milk during infancy. ACTA ACUST UNITED AC 2010; 110:702-9. [PMID: 20430131 DOI: 10.1016/j.jada.2010.02.013] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2009] [Accepted: 11/16/2009] [Indexed: 10/19/2022]
Abstract
BACKGROUND Existing literature suggests prenatal participation in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) may reduce breastfeeding among low-income mothers. However, little is known about whether the timing of WIC entrance during pregnancy influences infant feeding decisions. OBJECTIVE This study assesses the association between the timing of prenatal participation in WIC and various infant feeding practices, including breastfeeding initiation, breastfeeding for at least 4 months, exclusive breastfeeding, formula feeding, and early introduction of cow's milk and solid food. DESIGN Cross-sectional survey matching of birth certificate data to mothers' interviews 9 months after the child's birth. Mothers provided information on participation in the WIC program, infant feeding practices, and sociodemographic characteristics. SUBJECTS A nationally representative sample of 4,450 births in 2001 from the Early Childhood Longitudinal Survey-Birth Cohort. ANALYSES Multivariate logistic regression techniques (using STATA 9.0 SE, Stata Company, College Station, TX) estimated the relationship between the timing of prenatal WIC participation and infant feeding practices. RESULTS Entry into the WIC program during the first or second trimester of pregnancy is associated with reduced likelihood of initiation of breastfeeding and early cow's milk introduction; and entry during the first trimester is associated with reduced duration of breastfeeding. WIC participation at any trimester is positively related to formula feeding. CONCLUSIONS Prenatal WIC participation is associated with a greater likelihood of providing babies infant formula rather than breastmilk after birth. Findings also indicate that there are critical prenatal periods for educating women about the health risks of early cow's milk introduction. Given the health implications of feeding infants cow's milk too early, WIC may be successful in educating women on the health risks of introducing complementary foods early, even if direct counseling on cow's milk is not provided.
Collapse
|
29
|
|
30
|
Gallup GG, Nathan Pipitone R, Carrone KJ, Leadholm KL. Bottle feeding simulates child loss: Postpartum depression and evolutionary medicine. Med Hypotheses 2010; 74:174-6. [DOI: 10.1016/j.mehy.2009.07.016] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2009] [Accepted: 07/05/2009] [Indexed: 11/15/2022]
|
31
|
Heinig MJ, Dewey KG. Health effects of breast feeding for mothers: a critical review. Nutr Res Rev 2009; 10:35-56. [PMID: 19094257 DOI: 10.1079/nrr19970004] [Citation(s) in RCA: 94] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Lactation results in a number of physiological adaptations which exert direct effects on maternal health, some of which may confer both short and long term advantages for breast feeding mothers. Breast feeding in the early postpartum period promotes a more rapid return of the uterus to its prepregnant state through the actions of oxytocin. Breast feeding may also lead to a more rapid return to prepregnancy weight. Among studies that had good data on duration and intensity of lactation, the majority show a significant association between lactation and weight loss. However, there is no evidence that lactation prevents obesity. Lactation also affects glucose and lipid metabolism. The long term effects of these adaptations are unknown but may have implications for preventing subsequent development of diabetes and heart disease. Lactation delays the return of ovulation and significantly reduces fertility during the period of lactational amenorrhoea. This process is linked with feeding patterns and may therefore be affected by practices such as scheduled feedings and the timing of introduction of complementary foods. While the evidence from epidemiologic studies is mixed, several large studies have shown that extended lactation is associated with reduced risk of premenopausal breast, ovarian and endometrial cancers. Although bone mineralization declines during lactation, repletion takes place after weaning. As a result, breast feeding does not appear to cause long term depletion of bone nor does it increase risk of osteoporosis. Many of the physiological effects of lactation are dependent on the stimulation of the hypothalamic-pituitary axis and milk removal and thus may vary with infant feeding practices. Well controlled studies are needed that include detailed information regarding infant feeding practices in addition to the total duration of any breast feeding. Future feeding recommendations should reflect careful consideration of how such practices affect both infant and maternal health.
Collapse
Affiliation(s)
- M J Heinig
- Department of Nutrition, University of California, Davis, CA 95616, USA
| | | |
Collapse
|
32
|
Schulze PA, Zhao B, Young CE. Beliefs About Infant Feeding in China and the United States: Implications for Breastfeeding Promotion. Ecol Food Nutr 2009; 48:345-68. [DOI: 10.1080/03670240903170475] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
|
33
|
Hetzner NMP, Razza RA, Malone LM, Brooks-Gunn J. Associations among feeding behaviors during infancy and child illness at two years. Matern Child Health J 2008; 13:795-805. [PMID: 18839293 DOI: 10.1007/s10995-008-0401-x] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2008] [Accepted: 07/30/2008] [Indexed: 11/28/2022]
Abstract
OBJECTIVES To explore the different combinations of early feeding practices and their association with child illness in toddlerhood (i.e., asthma, respiratory infections, gastrointestinal infections, and ear infections). METHODS The Early Child Longitudinal Study-Birth Cohort (ECLS-B) offers a unique opportunity to address this issue, as the study features a nationally representative sample of children and includes important questions on early feeding behaviors as well as an extensive list of background characteristics on the families. Using a subsample of approximately 7,900 children from the ECLS-B, data from the 9 month and 2 year collections were analyzed to define the occurrence of three feeding practices during infancy (i.e., by age 6 months) identify the key combinations of these practices, and examine associations between these combinations and child illness via logistic regression. RESULTS Results indicate that 70% of parents initiated breastfeeding, 78% introduced formula and/or solid food before 6 months, 74% introduced solid food, and 15% introduced finger foods before 6 months. The most frequent feeding combinations were: breast milk with formula and solid/finger food (36%), formula with solid/finger food (24%), breast milk with formula (11%), breast milk with solid/finger food (14%), exclusive breast milk (8%), and exclusive formula (7%). After controlling for key demographic and family characteristics, results indicated that children who were exclusively breastfed were less likely to experience respiratory or ear infections than those experiencing other feeding combinations. No differences were found in rates of asthma or gastrointestinal infections. CONCLUSIONS This study provides insights for parents, medical professionals, and policy makers on the typical feeding practices and best practices for positive health outcomes in early childhood.
Collapse
Affiliation(s)
- Nina M Philipsen Hetzner
- NCCF, Department of Human Development at Teachers College, Columbia University, 525 West 120th Street, 39, New York, NY 10027, USA.
| | | | | | | |
Collapse
|
34
|
Grjibovski AM, Ehrenblad B, Yngve A. Infant feeding in Sweden: socio-demographic determinants and associations with adiposity in childhood and adolescence. Int Breastfeed J 2008; 3:23. [PMID: 18793452 PMCID: PMC2553767 DOI: 10.1186/1746-4358-3-23] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2007] [Accepted: 09/16/2008] [Indexed: 11/29/2022] Open
Abstract
Background Recent reviews and meta-analyses conclude that breastfeeding constitutes a small but consistent protective effect against obesity or higher values of body mass index (BMI) in children, though in some studies this effect was weakened after adjustment for potential confounders. The aim of this study was to explore the socio-demographic determinants of the duration of breastfeeding in Sweden and the associations between breastfeeding duration and adiposity in childhood and adolescence. Methods This was a cross-sectional study of Swedish children. Height, weight and waist circumference were measured and the sum of five skin fold measurements were obtained in 1137 9- and 15-year old children. Breastfeeding data were retrospectively obtained from the medical records for 812 (71.4%) children. Multiple ordinal logistic regression was applied to study individual effects of the maternal characteristics on the duration of breastfeeding. The relationship between children's anthropometric characteristics and duration of breastfeeding was studied by multiple linear regression. Associations between the odds of being overweight or obese and the duration of breastfeeding were studied by multiple logistic regression. Both linear and logistic models were adjusted for children's age, gender, birth weight, maternal education and parental BMI in 1998 as well as maternal age and smoking status at childbirth. Results Maternal education was positively associated with the duration of breastfeeding in both 1983 and 1989. Non-smoking mothers were more likely to breastfeed longer than smokers in 1989 (OR = 1.9, 95%CI: 1.3, 3.0). Fifteen-year old children breastfed for shorter than 2 months had 1.2 kg/m2 (95%CI: 0.1, 2.4) higher BMI, 3.2 cm (95%CI: 0.2, 6.2) higher waist circumference and 10.6 mm (95%CI: 1.7, 19.6) higher sum of five skin fold measurements compared to those breastfed for 6 months or longer when adjusted for children's characteristics and maternal characteristics in 1998. Adjustment for maternal age and smoking status at childbirth weakened these associations to non-significant levels (0.9 kg/m2, 95%CI: -0.4, 2.1; 1.4 cm, 95%CI: -1.5, 4.4 and 5.1 mm, 95%CI: -4.0, 14.2, respectively). In the 9-year olds, the associations were less pronounced, but in the same direction. No trends between duration of breastfeeding and children's anthropometric characteristics were observed in any of the age groups. Conclusion Maternal education and smoking were significant predictors of breastfeeding duration in Sweden in the 1980s. Associations with measures of adiposity were observed only in 15-year old children between the children with shortest and longest breastfeeding duration, which were weakened after adjustment for maternal characteristics at childbirth.
Collapse
Affiliation(s)
- Andrej M Grjibovski
- Unit for Public Health Nutrition, Department of Biosciences and Nutrition, Karolinska Institutet, SE-141 57, Huddinge, Stockholm, Sweden.
| | | | | |
Collapse
|
35
|
McMillan B, Conner M, Woolridge M, Dyson L, Green J, Renfrew M, Bharj K, Clarke G. Predicting breastfeeding in women living in areas of economic hardship: Explanatory role of the theory of planned behaviour. Psychol Health 2008; 23:767-88. [DOI: 10.1080/08870440701615260] [Citation(s) in RCA: 49] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
|
36
|
Research methodologies to investigate the experience of breastfeeding: a discussion paper. Int J Nurs Stud 2008; 45:1823-30. [PMID: 18514199 DOI: 10.1016/j.ijnurstu.2008.04.008] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2008] [Revised: 04/04/2008] [Accepted: 04/19/2008] [Indexed: 11/23/2022]
Abstract
This paper is a discussion of the importance of choosing appropriate methodologies to research the breastfeeding experience of women in the United Kingdom. Despite a plethora of research emphasising the benefits of breastfeeding to maternal and infant health, there is a relative dearth of research from the United Kingdom about women's experiences of breastfeeding. In order to understand the inherent complexities of successfully promoting and supporting breastfeeding, a mothers' breastfeeding experience must be examined within her specific context. This is increasingly recognised as a vital tool in providing effective support by health care professionals in extending breastfeeding duration. As such, this highlights the importance that appropriate methodologies are chosen through which to explore this phenomenon from the perspective of those experiencing it. This paper debates the importance of philosophical lines of enquiry in relation to breastfeeding research, and argues that engaging with ontological perspectives would offer opportunities for researchers to engage with women's understanding of breastfeeding in today's society. A hermeneutic phenomenological approach that is informed from feminist methodologies is deemed the most appropriate in researching mothers' views of breastfeeding.
Collapse
|
37
|
Intervention to promote exclusive breast-feeding for the first 6 months of life in a high HIV prevalence area. AIDS 2008; 22:883-91. [PMID: 18427207 DOI: 10.1097/qad.0b013e3282f768de] [Citation(s) in RCA: 72] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVES We report on a nonrandomized intervention cohort study to increase exclusive breast-feeding rates for 6 months after delivery in HIV-positive and HIV-negative women in KwaZulu-Natal, South Africa. METHODS Lay counselors visited women to support exclusive breast-feeding: four times antenatally, four times in the first 2 weeks postpartum and then fortnightly to 6 months. Daily feeding practices were collected at weekly intervals by separate field workers. Cumulative exclusive breast-feeding rates from birth were assessed by Kaplan-Meier analysis and association with maternal and infant variables was quantified in a Cox regression analysis. FINDINGS One thousand, two hundred and nineteen infants of HIV-negative and 1217 infants of HIV-positive women were followed postnatally. Median duration of exclusive breast-feeding was 177 (R = 1-180; interquartile range: 150-180) and 175 days (R = 1-180; interquartile range: 137-180) in HIV-negative and HIV-positive women, respectively. Using 24-h recall, exclusive breast-feeding rates at 3 and 5 months were 83.1 and 76.5%, respectively, in HIV-negative women and 72.5 and 66.7%, respectively, in HIV-positive women. Using the most stringent cumulative data, 45% of HIV-negative and 40% of HIV-positive women adhered to exclusive breast-feeding for 6 months. Counseling visits were strongly associated with adherence to cumulative exclusive breast-feeding at 4 months, those who had received the scheduled number of visits were more than twice as likely to still be exclusively breast-feeding than those who had not (HIV-negative women: adjusted odds ratio: 2.07, 95% confidence interval: 1.56-2.74, P < 0.0001; HIV-positive women: adjusted odds ratio: 2.86, 95% CI 2.13-3.83, P < 0.0001). CONCLUSION It is feasible to promote and sustain exclusive breast-feeding for 6 months in both HIV-positive and HIV-negative women, with home support from well trained lay counselors.
Collapse
|
38
|
Bishop H, Cousins W, Casson K, Moore A. Culture and Caregivers: Factors Influencing Breastfeeding among Mothers in West Belfast, Northern Ireland. ACTA ACUST UNITED AC 2008. [DOI: 10.1080/13575270701868785] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
|
39
|
|
40
|
Spatz DL, Pugh LC. The integration of the use of human milk and breastfeeding in baccalaureate nursing curricula. Nurs Outlook 2007; 55:257-63. [DOI: 10.1016/j.outlook.2007.07.003] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2007] [Indexed: 10/22/2022]
|
41
|
Abstract
Breastfeeding, particularly for the first 6 months of life, is unquestionably the ideal way to feed most infants. However, the human immunodeficiency virus (HIV) pandemic has caused debate and confusion about the best way for HIV-positive mothers to feed their children. This review provides recent key findings and opinions around making breastfeeding safer for HIV-positive women, and argues for preservation of breastfeeding, as opposed to complete avoidance of breastfeeding for all HIV-positive women.
Collapse
Affiliation(s)
- H M Coovadia
- Centre for HIV/AIDS Networking, University of KwaZulu-Natal, Durban, South Africa.
| | | |
Collapse
|
42
|
Law SM, Dunn OM, Wallace LM, Inch SA. Breastfeeding Best Start study: training midwives in a 'hands off' positioning and attachment intervention. MATERNAL & CHILD NUTRITION 2007; 3:194-205. [PMID: 17539888 PMCID: PMC6860895 DOI: 10.1111/j.1740-8709.2007.00083.x] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
The most common reasons cited by women for giving up breastfeeding early can be attributed to ineffective positioning and attachment and are therefore preventable. This study aimed to determine whether a 4-h training programme in 'hands off' positioning and attachment support increases midwives' knowledge and problem-solving skills. Using an unrelated comparison group and a pre- and post-intervention design, 108 midwives (experimental group) completed a 4-h standard breastfeeding training workshop focusing on effective positioning and attachment and the use of hands-off teaching methods. Knowledge and problem-solving skills were assessed using a modified form of the previously validated Breastfeeding Support Skills Tool. Pre- and post-training scores were compared with those of 27 student midwives (control group) who undertook the same assessments but without the breastfeeding training. Baseline knowledge scores of the midwives and the student midwives did not differ significantly (average difference 0.7 points to qualified midwives' advantage, 95% CI = -3.4 to 1.9). Following training, the qualified midwives' total scores increased significantly (7.2 points, 95% CI = 6.2-8.2). Minimal changes (1.4 points, 95% CI = -0.15 to 2.9) in students' scores were found. The additional increase owing to training above that which might be expected due to practice (i.e. the average difference in change scores between the two groups) was 5.8 points (95% CI = 3.75-7.96), representing a large effect size for the training (d = 0.95). There is a large variation in the breastfeeding knowledge of midwives working in post-natal care and, on average, they are no more skilled than senior student midwives. The study has shown that a 4-h workshop in a positioning and attachment intervention, using a 'hands-off' approach, can increase midwives' knowledge of breastfeeding support relevant to the immediate post-natal period. It is applicable to all midwives, and could be a cost-effective way of improving the ability of mothers to begin and continue to breastfeed successfully.
Collapse
Affiliation(s)
- Susan M Law
- Department of Nursing, Midwifery and Health Care, Coventry University, Coventry, UK.
| | | | | | | |
Collapse
|
43
|
Abstract
OBJECTIVES This study describes sleep patterns for mothers and fathers after the birth of their first child and compares exclusive breast-feeding families with parents who used supplementation during the evening or night at 3 months postpartum. METHODS As part of a randomized clinical trial, the study utilized infant feeding and sleep data at 3 months postpartum from 133 new mothers and fathers. Infant feeding type (breast milk or formula) was determined from parent diaries. Sleep was measured objectively using wrist actigraphy and subjectively using diaries. Lee's General Sleep Disturbance Scale was used to estimate perceived sleep disturbance. RESULTS Parents of infants who were breastfed in the evening and/or at night slept an average of 40-45 minutes more than parents of infants given formula. Parents of infants given formula at night also self-reported more sleep disturbance than parents of infants who were exclusively breast-fed at night. CONCLUSIONS Parents who supplement their infant feeding with formula under the impression that they will get more sleep should be encouraged to continue breast-feeding because sleep loss of more than 30 minutes each night can begin to affect daytime functioning, particularly in those parents who return to work.
Collapse
Affiliation(s)
- Therese Doan
- Department of Family Health Care Nursing, School of Nursing, University of California at San Francisco, CA 94143, USA
| | | | | | | |
Collapse
|
44
|
Abstract
Homo sapiens has developed during the course of over two million years. The social and physical conditions of life, the availability of milk and infant foods as well as the presence of diseases have all undergone radical transformations from the Stone Age, at first without and then with fire, to the hunter–gatherer, farmer–herder, agricultural and, now, developed societies. These changes in the human environment may have induced modifications in the length of pregnancy, the development of the neonate at birth, the duration of lactation, the composition of breast milk and use of weaning foods and milk substitutes. Darwinian selection for the nutrient, anti-infective and other components of breast milk may have been determined by the effects of nutrition, through genetic variations in milk composition, on the survival of infants and perhaps also on fecundity and disease resistance in later adult life. Today Darwinian selection may no longer be effective in maintaining or modifying human mammary function, because modern hygienic environments, together with the availability of nutritionally adequate breast-milk substitutes, permit infant survival even under conditions of total lactational failure. National and international promulgations strictly control the composition of infant formulas offered as breast-milk substitutes or as weaning foods. These recommendations are modified as beliefs suggest, and research indicates, the effects of nutrients and other factors on the health and well-being of the child. Preliminary observations on child health have often proved valuable in furthering research. Unquestioning acceptance of apparently desirable, but untested, epidemiological associations have led to unexpected but dangerous iatrogenic problems. Recommendations for change cannot safely be made without proper comparisons with present products and procedures under practical conditions. Such tests are time consuming and require protocols of appropriate statistical design and power while still meeting the required sociological and ethical constraints, but are essential to identify possible harmful effects of any proposed change. It is suggested that no novel ingredients should be added, or major changes permitted in any component, until appropriate trials have established the value and safety of the proposed modifications. Breast-feeding is vital to maximize infant survival in developing countries. There are major difficulties in assessing any differences in morbidity and mortality of breast-fed v. artificially reared infants in the developed world. Carefully controlled studies with comparisons of health and well-being, not only in infancy but throughout life, are desirable if the effects of infant nutrition on adult well-being, suggested by epidemiological studies, are to be validated and ultimately applied. There are considerable variations in the composition of breast milk. This variance suggests that it may ultimately be possible to design formulas better able to meet the needs of individual infants than the milk available from the mother's breast.
Collapse
|
45
|
Abstract
The relationship of low prepregnant body mass index with breastfeeding was investigated in 1272 women who delivered a term infant with birthweight > or = 2500 g at the San Paolo Hospital in Milan, Northern Italy. Underweight was defined using the Institute of Medicine's cutoff of 19.8 kg/m(2). Women were interviewed via telephone through 12 months postdelivery about breastfeeding practices. Education level (high versus low, odds ratio [OR], 1.41), primiparity (OR, 1.35), vaginal delivery (OR, 0.74), and birthweight of the infant (normal versus high, OR, 1.89) were associated with low, as opposed to normal, pre-pregnant body mass index. After adjustment for these confounders, no difference was found between underweight and normal weight women for initiation or duration of breastfeeding (mean adjusted difference, 0.4; 95% confidence interval [95% CI], -0.1 to 0.9 months) or exclusive breastfeeding (0.1 [95% CI, -0.1 to 0.3] months). Underweight mothers of healthy term infants may not be at increased risk for not initiating or shorter breastfeeding.
Collapse
Affiliation(s)
- Marcello Giovannini
- Department of Pediatrics, San Paolo Hospital, University of Milan, Milan, Italy
| | | | | | | |
Collapse
|
46
|
Giles M, Connor S, McClenahan C, Mallett J, Stewart-Knox B, Wright M. Measuring young people’s attitudes to breastfeeding using the Theory of Planned Behaviour. J Public Health (Oxf) 2007; 29:17-26. [PMID: 17204510 DOI: 10.1093/pubmed/fdl083] [Citation(s) in RCA: 61] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND The focus of this study was to design and pilot a questionnaire to measure young people's attitudes to breastfeeding using the Theory of Planned Behaviour (TPB). This is intended for subsequent use in a large-scale attitude survey, which in turn will inform the design of a breastfeeding intervention programme with adolescents. METHODS The first three phases of a research programme employing the theory are described: belief elicitation, questionnaire development and a pilot study. Firstly, an elicitation study to identify the modal salient beliefs underlying young peoples' motivations to breastfeed, using six semi-structured focus groups with 48 young people, was performed. Secondly, the measurement instrument was constructed, incorporating all the key theoretical constructs and both direct and belief-based measures. The questionnaire was then piloted on a sample of 121 female and male schoolchildren to identify and assess the relative importance of the determinants of breastfeeding intention. RESULTS The questionnaire proved to be reliable, and preliminary analysis provided strong support for the predictive power of the TPB. CONCLUSIONS Some key issues involved in the operationalization of the theory are highlighted, which may be of interest to researchers involved in the design of TPB questionnaires for use in other intervention programmes.
Collapse
Affiliation(s)
- Melanie Giles
- Psychology Research Institute, School of Psychology, University of Ulster, Cromore Road, Coleraine County, Londonderry BT52 1SA, UK
| | | | | | | | | | | |
Collapse
|
47
|
Abstract
This review examines an age-old approach to parenting recently rediscovered in Western industrialized societies and known by names such as natural parenting, attachment parenting, and instinctive parenting. Its leading principle is utmost sensitivity to the child's innate emotional and physical needs, resulting in extended breastfeeding on demand, extensive infant carrying on the caregiver's body, and cosleeping of infant and parents. The described practices prevailed during the evolutionary history of the human species and reflect the natural, innate rearing style of the human species to which the human infant has biologically adapted over the course of evolution. An overview of research from diverse areas regarding psychological as well as physiological aspects of early care provides evidence for the beneficial effects of natural parenting. Cross-cultural and historical data is cited to reveal the widespread use of the investigated parenting style. It is concluded that the described approach to parenting provides the human infant with an ideal environment for optimal growth both psychologically and physiologically. It is yet to be determined how much departure from this prototype of optimal human parenting is possible without compromising infant and parental wellbeing. The review also invites a critical reevaluation of current Western childrearing practices.
Collapse
Affiliation(s)
- Regine A. Schön
- Department of Psychology, University of Helsinki, Helsinki, Finland
| | - Maarit Silvén
- Department of Psychology, University of Tampere, Tampere, Finland
| |
Collapse
|
48
|
Wallace LM, Dunn OM, Alder EM, Inch S, Hills RK, Law SM. A randomised-controlled trial in England of a postnatal midwifery intervention on breast-feeding duration. Midwifery 2006; 22:262-73. [PMID: 16380197 DOI: 10.1016/j.midw.2005.06.004] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2004] [Revised: 06/01/2005] [Accepted: 06/15/2005] [Indexed: 11/24/2022]
Abstract
OBJECTIVE To determine whether postnatal 'hands off' care by midwives on positioning and attachment of the newborn baby improves breast-feeding duration. DESIGN Mothers were randomised at the first postnatal feed to receive either care by a midwife trained in the experimental protocol or by a control midwife undertaking routine care. SETTING Eight wards in four English Midlands hospitals. PARTICIPANTS 370 primiparous mothers with term babies who intended to breast feed, and could sit out of bed to do so. INTERVENTIONS Experimental protocol of verbal-only advice on positioning and attachment, delivered at the first postnatal ward feed compared with routine care by a qualified midwife. MAIN OUTCOME MEASURES Duration of breast feeding up to 17 weeks as assessed by diaries and interviews with mothers and protocol adherence from self-completed checklist by the midwife. The mothers' self-reported experience of care and support before, during and after delivery were assessed at 6 weeks, and feeding outcomes and employment status at 17 weeks. FINDINGS Experimental group mothers more often held the baby across their lap and received 'hands off advice', but fewer babies in the experimental than control groups attached and fed: 59% (106/180) vs. 67% (118/175), p=0.1. No significant differences were found in the numbers of mothers breast feeding at 6 or 17 weeks in the experimental and control groups (stopped exclusive breast feeding: 76% (130/172) vs. 77% (126/163) at 6 weeks; 96% (167/174) vs. 96% (161/168) at 17 weeks; odds ratio 1.02, 95% CI 0.77 to 1.22; p=0.8; stopped any breast feeding: 35% (61/172) vs. 32% (53/167) at 6 weeks; 63% (109/173) vs. 60% (101/167) at 17 weeks; odds ratio 1.10, 0.84 to 1.45; p=0.5). There were no significant differences in the incidence of problems with breast feeding and care experienced by mothers before or during hospitalisation (other than at the first postnatal ward feed), nor after discharge home. CONCLUSIONS No significant beneficial effect was found on breast-feeding duration of the verbal- only advice on positioning and attachment, perhaps because aspects of the intervention are already within routine UK practice. Other care practices at subsequent feeds may negate benefits of care at earlier feeds. 'Hands off' care at the first feed may be less important to subsequent feeding than achieving a first feed under supervision in the postnatal ward. IMPLICATIONS FOR PRACTICE Midwives can be trained in a 4-hr workshop to achieve improved knowledge of 'hands off' positioning and attachment care, and these can be translated into clinical practice. Future studies should differentiate the elements of the care that are effective in achieving postnatal feeds, and apply this advice consistently at successive feeds.
Collapse
Affiliation(s)
- Louise M Wallace
- Health Services Research Centre, GE404, School of Health, Coventry University, Priory Street, Coventry CV1 5FB, UK.
| | | | | | | | | | | |
Collapse
|
49
|
Abiona TC, Onayade AA, Ijadunola KT, Obiajunwa PO, Aina OI, Thairu LN. Acceptability, feasibility and affordability of infant feeding options for HIV-infected women: a qualitative study in south-west Nigeria. MATERNAL AND CHILD NUTRITION 2006; 2:135-44. [PMID: 16881926 PMCID: PMC6860690 DOI: 10.1111/j.1740-8709.2006.00050.x] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
The objective of this study was to explore the acceptability, feasibility, affordability, safety and sustainability of replacement feeding options for HIV-infected mothers in Ile-Ife, in south-west Nigeria. Six focus group discussions were conducted with a purposive sample of mothers, fathers and grandmothers. The HIV status of all participants was unknown to investigators. All text data were analysed using the Text-based Beta Software program. With regard to the acceptability of replacement feeds, respondents perceived the stigma associated with not breastfeeding to be an important consideration. In this community, breastfeeding is the norm--even though it is not necessarily exclusive. For infected mothers who choose to breastfeed exclusively and then to wean their infants before 6 months of age, respondents did not anticipate early cessation of breastfeeding to be problematic. Respondents noted that acceptable replacement foods included infant formula, soy milk and cow's milk. Barriers to replacement feeding that were mentioned included: the high costs of replacement foods and fuel for cooking; an unreliable supply of electrical power; poor access to safe water; and poor access to storage facilities. The research confirms the difficulty of replacement feeding for HIV-infected mothers in sub-Saharan Africa. The results also provide the basis for new issues and hypothesis for future research in other communities with similar socio-cultural and economic characteristics.
Collapse
Affiliation(s)
- Titilayo C Abiona
- Department of Community Health, Obafemi Awolowo University, Ile-Ife 220005, Nigeria.
| | | | | | | | | | | |
Collapse
|
50
|
Kiernan K, Pickett KE. Marital status disparities in maternal smoking during pregnancy, breastfeeding and maternal depression. Soc Sci Med 2006; 63:335-46. [PMID: 16472900 DOI: 10.1016/j.socscimed.2006.01.006] [Citation(s) in RCA: 64] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2005] [Indexed: 10/25/2022]
Abstract
One of the dramatic recent changes in family life in Western nations has been the rise in non-marital childbearing. Much of this increase is attributable to the growth in cohabitation. But in some countries, notably the UK (and the USA) this is much less the case with significant proportions of children being born to parents who are not living together. This study uses data from the Millennium Cohort Study, a British birth cohort established in 2001, to examine whether the closeness of the tie between parents, as assessed by their partnership status at birth, is related to smoking during pregnancy, breastfeeding and maternal depression. Four sets of parents are distinguished representing a hierarchy of bonding or connectedness: married and cohabiting parents, and two groups of solo mothers, those closely involved with the father at the time of the birth and those not in a relationship. Smoking in pregnancy, breastfeeding and maternal depression tests for trend, adjusted for socio-demographic factors, showed that there was a statistically increased risk of adverse health and health behaviours by degree of parental connectedness. There were also consistent and statistically significant differences between married and non-married mothers. Particularly noteworthy was the finding that cohabiting mothers have greater risk of adverse outcomes than married women. Among the non-married set, there were also differences in risk of adverse outcomes. For smoking in pregnancy, the key difference for continuing to smoke throughout the pregnancy lay between mothers involved with partners and those lacking an intimate relationship. For breastfeeding, stronger parental bonds were associated with initiation of breastfeeding, with a clear difference between cohabiting mothers compared to solo mothers. There was also an increased risk of maternal depression with looser parental bonding, and among non-married groups this increased risk was most noticeable among cohabiting mothers when compared with solo mothers.
Collapse
Affiliation(s)
- Kathleen Kiernan
- Department of Social Policy and Social Work, University of York Heslington, UK.
| | | |
Collapse
|